Giving consent to the ineffable

The transformative nature of psychedelic-assisted therapy raises an ethical question about whether patients can give informed consent, because they cannot fully anticipate the experience. This paper argues that patients often have sufficient knowledge to consent, as they know they want to change their negative status quo and that the therapy offers an effective way to do so. Even without anticipating the specific manifestation of a psychedelic experience, patients can understand what the transformative nature means for them and make a value-aligned choice.

Study at a glance

Abstract

A psychedelic renaissance is currently taking place in mental healthcare. The number of psychedelic-assisted therapy trials is growing steadily, and some countries already grant psychiatrists special permission to use psychedelics in non-research contexts under certain conditions. These clinical advances must be accompanied by ethical inquiry. One pressing ethical question involves whether patients can even give informed consent to psychedelic-assisted therapy: the treatment’s transformative nature seems to block its assessment, suggesting that patients are unable to understand what undergoing psychedelic-assisted therapy actually means for them and whether it aligns with their values. The present paper argues that patients often have sufficient knowledge to give informed consent because they know that they want to change their negative status quo and that psychedelic-assisted therapy offers an effective way to do so. Accordingly, patients can understand what the transformative nature of psychedelic-assisted therapy means for them and a make a value-aligned choice even if they are unable to anticipate the manifestation of a psychedelic experience